Published on 12, July, 2020
Hello,I'm a 38 year old female and I think I may have Asperger's. My GP is going to refer me for an assessment.
I've always found socialising difficult, but thought I was just shy or had social anxiety. But recently I noticed something worrying: I keep falling out with friends or offending them without intending to. I don't know if this is a symptom of Asperger's or not? Could someone clarify this? The worrying thing was that I couldn't predict when it was going to happen, and sometimes I didn't even understand why it had happened. That's when I started researching and trying to find out what the problem could be. When I read about Asperger's, and symptoms like 'masking', I realised that I have masked all my life. I realised that maybe the reason I have low self esteem is because I could never understand why I couldn't be social like others could.
Anyway, I am very pleased to have found this community. Thank you! It is great to know that I'm not alone in this experience.
I have some questions about diagnosis. I am somewhat worried because I understand that many high-functioning autistic females are misdiagnosed. I've read that if you do get an Asperger's diagnosis, you can access help and support. Can anyone tell me what kind of help you can access, specifically in terms of therapy: can you get help developing social skills, and help for low self esteem and anxiety, for example? What kind of therapy is it? Can you get to the stage where you can function more easily and get less anxious?
If I get diagnosed as NOT autistic, can I still participate in this forum? I guess I could still read self-help books for Asperger's, and use what is relevant? I am currently on the waiting list for CBT for anxiety (I have had therapy several times in my life, for issues including an eating disorder, low self esteem, anxiety, and insomnia, and I'm currently waiting for more therapy). I suppose I could tell the therapist that I suspect I have Asperger's, but they wouldn't be able to give me specialist help for autism, but perhaps they could help me with social anxiety.
Thank you!
Hello Ultramarine,
Nice to meet you. You have a number of questions there:
On the friendship thing, it not a symptom as such but a very common experience - I think some of the others have commented admirably on that and it's happened to me on occasion..
On women, girls, people whose gender identity isn't binary and men who don't fit the stereotyped "male" presentation- yep! I hear so many stories of them being missed. There's a lot on you tube about women and diagnosis. As my boss who is a teacher and well aware of this put it: "We often pick up on the boys because they melt down in class, throw chairs across the room and hang out of the window telling the world to effe off. The girls we often miss because they have their heads down at the back of class either shutting down or getting on with their work only to melt down later at home". Not only that but all the early research was done on boys with that "male" presentation. I suspect there are some assessors out there who are still not trained well enough to pick up the other possible presentations or autism when it's covered by masking. There are some folks on this site who have reported they or their girls, in particular, have been assessed and seem to have been dismissed because they are superficially passing as socially OK for an hour.
This in turn can feed into the issue of misdiagnosis. MH services often pick up on things like OCD and eating disorders, but fail to spot that autism is behind the development of these problems and why they don't often respond well to therapies for NTs, or else completely misdiagnose and tell people they have personality disorders etc when they don't. I'm only just beginning to understand I have the chronic phobias I do because of sensory experiences related to probable ASC. And MH services have never picked up on any of the ample clues I now realise I'd been giving them of either autism or some other sensory issue. I had to work that one out for myself. I certainly believe that if ASC is in the mix it is important to tease apart what is due to ASC and what is an MH issue.
Moreover, there is a growing body of research which says that with ASC MH problems need to be addressed very differently as it can affect which meds should or shouldn't be prescribed and the therapeutic approach in talk therapies because the interactions and communicative and cognitive styles are so different.
So, I think in your position you are doing a wise thing in going for an assessment. And yeah, I'd tell any therapist I was working with I was waiting for one. It could help. I've had endless problems with NHS services, but have a private counsellor now. I told him and he's treating "as if" while we await an assessment and that IS helping matters A LOT.
If they don't diagnose you as autistic and you are satisfied they have looked properly under the surface of things, then the process might still prove very helpful. I think there are a lot of folks out there, - and I might turn out to be one, who knows? - who meet a lot but not all of the criteria for the diagnosis. We're all on a human spectrum somewhere after all, and it might well be that the traits you DO have are nonetheless causing problems/benefits for you in some respects the same as, or similar to people who do meet all of the criteria. Again teasing apart which traits you do and don't have might help you understand yourself better and find some strategies which work better for you. And yes of course you'll be welcome on the forum.
As for the point on support,...I've yet to find out myself what's there for me and what's not. I guess the others will have some very variable stories. For me, for now, the best help I'm getting is from my private counsellor, my boss and my dentists, lol.
Hi Dawn,
Thanks very much for your reply. I'm interested to know, what sort of therapy are you having from your private counsellor? Is it CBT or another type of therapy, and is he changing the approach at all to reflect your possible diagnosis?I was having CBT for low self-esteem and insomnia a few years ago, and I told the therapist that I wondered if I might be autistic. She said straight away that she could tell that I wasn't. (This was before I had started looking back over my life and seeing lots of possible evidence, and researching Asperger Syndrome, which I've been doing in the last few years). It's only recently that I discovered that it's possible to be autistic and appear 'normal' to most people. My doctor has agreed to refer me for an assessment, anyway. Recently I contacted an acquaintance whose son has Asperger Syndrome, I told him I thought I might be autistic and asked him what the testing process involves. I thought he would say I wasn't, but to my surprise he said 'speaking frankly, I always thought you were an Aspie' and he said he had seen signs in me that he has seen in his son. I asked him if he could make a list of those signs that I could send in to my doctor. I've known him for a few years but he never said anything earlier. Perhaps it's better this way, as I might not have accepted it if he'd said something earlier.Thanks for your comments about how useful the process might be, even if it turns out I'm not autistic. I'm in the process of writing down all the signs that I've noticed over the years, and I'm going to send the list to my doctor who will hopefully be able to send it to the assessment team. It's quite a distressing process to write down all the social mistakes I've made over the years, and all the ways that I've felt different, but it is helping me clarify the problem, and if I'm not autistic then I can still show it to whichever therapist I end up working with.It's good to know that I'm welcome on the forum whatever happens. This seems like a very nice community. It's surprising (or maybe not surprising) that whatever problems you have, many others have experienced the same thing, even if it feels like you are the odd one out to begin with.
PS - Dawn, I noticed in another conversation on this forum that you said you were going to be assessed at a special centre for diagnosing adult autistic women (if I understood correctly). Were you able to specify to your GP that you wanted to be assessed there, or did you refer yourself privately?
He was very friendly, aware that the assessment was anxiety-causing for me, and very thorough. However, 45 minutes into the assessment he said, "I am confident in giving you a diagnosis of ASC", then went on to discuss some comorbid conditions I have. However, the drug he prescribed for my mild depression (Sertraline) just triggered migraines in me - just my luck!
Hi Dawn and ItsMyMind,I thought you might be interested in this: I contacted the Lorna Wing Centre and they said that their centre isn't one of the options under Patient Choice. This is what they said:
Please note that the Lorna Wing Centre does not hold a block NHS contract with your local Clinical Commission Group (CCG) and therefore we will not be one of the service options under Patient Choice. You will therefore need to discuss a referral to our service with your GP.
If your GP agrees to refer you to our service we would need a completed referral form from yourself and a referral letter from your GP which needs to state clearly that they support the referral and will apply for an Individual Funding Request (IFR) through your local CCG. Your referral will then be reviewed by our clinical team and we will confirm acceptance of the referral to you and your GP, if it is appropriate for our service and provide the costings. Your GP will then be required to apply for an Individual Funding Request (IFR) on your behalf through the CCG. If funding is agreed by the CCG we will require confirmation in writing from them before we can proceed with providing an assessment for you.
You could also contact your Clinical Commissioning Group, ask to speak to the Commissioner for adult mental health and get the information direct. Then you’ll be in a position of knowledge and can inform the GP the process they are obliged to follow ;-)
ItsMyMind,Thanks for sharing this link - I appreciate it!Do they have a similar application form for ASD assessments? This one seems to be for ADHD.Thanks for taking the time to let me know about this.
Hi ItsMyMind,Thanks so much for letting me know!
I didn't know what a CCG was, so I Googled it and think I roughly understand. It's the group who fund NHS healthcare in a local area; is that right?
Fantastic to hear that you didn't need to wait for two years! How were you able to be seen sooner?
Hi Martin, thanks for letting me know about this. It's good to hear that you were seen so quickly. How did you find the psychiatrist?
I'll look into that. I asked my GP. He said "no".
Psychiatry UK was the provider btw - there is reference to the Right to Choose guidance and a standard letter to give to your GP on their website: psychiatry-uk.com/.../